Purpose: This study aims to test the effects of patient-specific messaging smartphone application for patients with proven coronary artery disease (CAD) to enhance self-management of cardiovascular (CV) risk factors
Methods: The application for self-improvement (AnSim) trial was a single-blind, multicenter, randomized, controlled trial that recruited 120 patients who underwent percutaneous coronary intervention in our hospitals between December 2016 and April 2018. The patients were randomly assigned to intervention group (n=60) or control group (n=60), and patients in the intervention group (n=60) received 6 messages per week for 6months in addition to usual care. The Heart Keeper application developed by the Korean society of cardiology was commonly applied to both groups. The primary endpoint is a change in blood pressure at the 6th month. Secondary clinical endpoints include other CV risk factors, behavioral change, self-efficacy, quality of life, and satisfaction for the applications. Each variable will be re-evaluated at the 9th month to investigate the sustainability of changes after the intervention.
Result: At 6 months and 9 months, there was no significant difference in blood pressure between the two groups. (6 months: 124.1±16.5 vs 125.3±13.1, p-0.683 ; 9months: 126.8±14.4 vs 127.0±14.0, p=0.943) There were no significant differences between the two groups in other single variables such as body weight, blood glucose, total cholesterol level, and low-density lipoprotein cholesterol. When compares within the intervention group, The achieving rate for combined risk factor control (achieved target levels for 4 or more key risk factors among body weight, blood pressure, blood glucose, lipid level, and smoking cession) at 9 month was higher in the top 50% message user than lower 50% (48.4% vs. 13.8% , p=0.05)
Conclusion: Among patients with coronary heart disease, the use of a smart phone messaging service for CV risk factor did not show a short-term effect at 6th month. But at 9 month, it seems to be helpful for long term maintenance of CV risk factor control for patients with high application utilization.